La proteina 4 dell’epididimo umano (HE4) come marcatore di recidiva di carcinoma dell’ovaio

AUTORI

ABSTRACT

Human epididymis protein 4 (HE4) as a marker of ovarian cancer relapse

Carbohydrate antigen 125 (CA-125) is considered a good marker of ovarian cancer (OC) progression, although high CA-125 concentrations may be observed in several benign conditions, such as pelvic inflammatory disease and endometriosis. Recent studies sought to identify markers with improved specificity for OC detection and monitoring, highlighting interesting results only for HE4. The aim of this study was to evaluate HE4 as marker of OC relapse in 18 patients (50% in relapse) monitored after surgery and adjuvant chemotherapy. Serum HE4 and CA-125 concentrations were determined by ELISA and IRMA methods, respectively. Each patient contributed three serum samples drawn at 3-month intervals (between 1-3, 4-6 and 7-10 months from surgery). Concerning OC patients in remission, marker increase over the threshold level was observed only for CA-125 (n=3, 33%). Conversely, in patients with relapsed OC the increase of HE4 occurred in 22%, 78% and 89% of patients at 3, 6 and 10 months from treatment, respectively. The positivity for CA-125 was found later (7-10 months after surgery) and only in 44% of patients. According to the reference change value available only for CA-125 (69%), 11% of patients both in remission and in relapse showed a clinically significant CA-125 increase at 6 months. However, no further increase was later detectable in patients in remission. Conversely, 67% of patients with recurrent disease showed a further significant CA-125 increase in the following three months. In conclusion, although preliminarily, this study shows that HE4 is more specific and sensitive than CA-125 for the detection of OC relapse.

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